The Business of Pandemics

In 2006, international health expert Richard Feachem told audiences at Cambridge University at a Darwin lecture that the world’s capacity to deal with pandemics was dangerously inadequate. His interest then, as now, was combating various pandemics, many of which have slid into the background (malaria, HIV and AIDS). At stages, Feachem has painted doomsday scenarios of catastrophic disease, one being a pandemic flu which might well kill between 100 or 300 million people.

So what are we to make of this strain of swine flu, designated swine influenza A (H1N1)? The most important thing is that it might not be as dangerous as first thought, though details are still sketchy. The response of the Ford administration to swine flu in 1976 gave an object lesson in what happens when one overreacts. The entire episode was tragically comic, as it involved a complete misreading of what turned out to be a mild outbreak. Less mild were the results of the flu vaccination program: nasty side effects including several deaths were reported (the causal links have been disputed), followed by subsequent lawsuits and the destruction of the vaccine.

The first inclination in all of this is grading the response. Government report cards on the subject of fighting pandemics tends to be poor. Defenses are often haphazard and inadequate. Stumbling and bumbling often accompanies misunderstandings and heavy-handed responses. To the fiascos of 1976 can be added the dark memories of efforts taken to combat SARS (Severe Acute Respiratory Syndrome), which lead to brutal state measures against the infected. The mask became a feature of global travel in 2003, despite evidence that the condition was less contagious than thought. This did not stop countries from China, where it originated, to the US, from falling into a state of collective psychosis.

Prompt announcements informing the public, including the coordination of health services, are basic steps that might be initially taken. While the Mexican authorities are seemingly holding the fort well at the moment, 850 cases had already existed by the time announcements were made. The current figures stand at some 159 deaths, with 2,400 people infected.

Numbers of those who have contracted it in the US, according to the Centers for Disease Control and Prevention, are rapidly approaching a hundred (91 in 10 states). A Mexican toddler, who arrived with his parents on a visit, has died from it. Three have been found in Germany; four in Spain; five in Britain. Far-flung New Zealand has also had its sufferers. Dr. Keiji Fukuda, assistant director general of the World Health Organization is not necessarily giving us any more clues on its seriousness, resorting to the organization’s scale of emergency. Apparently, ‘we are not there yet’ in terms of pandemic levels, with ‘6’ being the most serious marker, and ‘5’ (‘human-to-human spread of the virus into at least two countries in one WHO region’) being the current category.

There is no sense of gripping hysteria as yet, but many venues for public gatherings (schools, gyms, restaurants, movie theatres), most notably in Mexico City, have been or are being closed. Some of these measures might prove needless and even ineffective. Even organizations such as the WHO have argued that some restrictions, such as those on travel, fall into the latter category.

This has not prevented several countries from considering travel bans, which will have the effect of estranging Mexico. Cuba and Argentina have banned flights to the country. The French health minister Roselyne Bachelot has called for the suspension of all flights leaving the European Union heading that way. She will be putting her case to colleagues in Luxembourg on Thursday.

Others are fairly nonplussed by the whole business, most notably many in the country where the flu was first noted. Mexicans interviewed on the ‘World Have Your Say’ segment on the BBC World Service were simply bored, deprived of local amusements and distractions. A caller was simply told do not bother traveling to Mexico City at this time, less because of a lethal disease than lack of entertainment. ‘Don’t come to Mexico – you will be bored.’ The editors at the Gawker site have simply this to say. ‘For the billion healthy kids in the Western hemisphere: you’re grounded.’

What is required, not merely with this pandemic, but with other conventional killers, is a global, coordinated effort that is effective yet restrained. Swine flu is lethal, but so are numerous other infections that rage against human populations. If nothing else, we might have swine flu to thank for galvanizing international efforts in combating potentially more serious pandemics. Or we might just be left with a cure that is worse than the disease.